It is a blood clot that from within a normally functioning vein. (Eg) leg and mostly occur in leg and also occur in other part of body such as arm.

DVT become classified as embolism. When it clot; DVT and PULMONARY EMBOLISM are dangerous because of their potential to become wedged. When the blood reaches the lungs and can cause an vary problems. Potentially cause death.

CAUSES

1. IN TRAUMA

the veins inner lining becomes damaged due to an injuries caused by a variety of factor including surgery.

Chondromalacia is a condition where the cartilage of the under surface of the knee cap undergoes wear and tear. Chondromalacia in other terms is called as Runners Knee as it is very common in athletes who involve specially in running. However it may equally affect other individuals too.

Chondromalacia can also occur in individuals with osteoarthritis of knee, young individuals who are obese, or in individuals with trauma to knee cap.

Movements are not harmful in the ordinary activities of daily living.\

BUT WHAT REALLY CAUSE OF THE INJURIES ARE

(A) Speed of movements.
(A) Fixed body positions.
(B) Some posture can cause discomfort.
(C) Unwanted posture maintained for prolonged period of time.
(D) Lack of time for recovery between them.

PREVENTION’S

(1) Proper ergonomic corrections.
(2) Often changing the body posture from one position to another.
(3) Free & strengthening exercise to maintain the muscle strength of the body.
(3) Exercises help to prevent further injuries.

KEY POINTS

SITTING

Rest your back firmly against the back of the chair.

Put a pre made support, a small cushion, behind your lower back.

If your using computer:

(i) The keyboard should be right in front of you and the monitor should be at eye level.
(ii) Try to keep your chin in tuck- in posture.
(iii) Mouse holding should be 90 degree angle at the elbow level.

Sudeck’s osteodystrophy is a condition of intense burning pain, stiffness, swelling, and discoloration that most often affects the hand. Arms, legs, and feet can also be affected by sudeck’s osteodystrophy.

1. Type 1 occurs after an illness or injury that did not directly damage a nerve in the affected area.

2. Type 2 follows a distinct nerve injury

EPIDEMIOLOGY

Sudeck’s atrophy is reasonably common – it may occur after as many as 5% of traumatic injuries. RSDS frequently occurs between the ages of 40 and 60 but also can occur in children and the elderly. It is more common among women.
Risk Factors:

1. It may occur spontaneously (i.e. without any cause) -but more commonly it follows trauma (fractures, ligament and muscle strains, nerve or soft tissue injuries) which may seem trivial.

2. It is believed to be due to prolonged immobilisation following the injury.

Although the two types of CRPS can be tied to injury or illness, the exact cause of CRPS is unknown. One theory is that a “short circuit” in the nervous system is responsible. This “short circuit” causes overactivity of the sympathetic (unconscious) nervous system which affects blood flow and sweat glands in the affected area.

SIGNS & SYMPTOMS

1. Early on there is throbbing, burning pain with the site red, warm and swollen

2. After weeks or months the overlying skin may become cold, mottled, and shiny with stiffness and often underlying osteoporosis

3. Later the pain continues, with associated muscle atrophy and there may also be contractures.

DIAGNOSIS

The diagnosis is clinical, however, an x-ray may reveal osteoporosis of the underlying bone later in the process. Bone scans, and magnetic resonance imaging (MRI) scans can help your doctor make a firm diagnosis.

TREATMENT

Early diagnosis and treatment are important in order to prevent CRPS from developing into the later stages.

2. Injection therapy. Injecting an anesthetic (numbing medicine) near the affected sympathetic nerves can reduce symptoms. This is usually recommended early in the course of CRPS in order to avoid progression to the later stages.

3. Biofeedback. Increased body awareness and relaxation techniques may help with pain relief.

4. PhysioTherapy. Active exercise that emphasizes normal use of the affected limb is essential to permanent relief of this condition. Physical and/or occupational therapy are important in helping patients regain normal use patterns. Medications and other treatment options can reduce pain, allowing the patient to engage in active exercise.

SURGICAL

If nonsurgical treatment fails, there are surgical procedures that may help reduce symptoms.

1. Spinal cord stimulator. Tiny electrodes are implanted along your spine and deliver mild electric impulses to the affected nerves.
2. Pain pump implantation. A small device that delivers pain medication to the spinal cord is implanted near the abdomen.

Results from surgical procedures may be disappointing. Many patients with chronic CRPS symptoms benefit from psychological evaluation and counseling.

Ulnar collateral ligament gets injured due to trauma or repeated actions or stress. Ulnar collateral ligament injury is very common in athletes mainly involved in tennis, badminton, javelin throwers, etc.. Fall on an out stretched hand can also lead to ulnar collateral ligament injury

A case of poly trauma. Patient was travelling in a bus where he was hit by a lorry on 26.06.2015.Patient C/O severe pain & inability to use both lower limbs. C/O inability to stand & walk. Patient was initially treated at Govt.Hospital near Vellore where he was treated conservatively with splints, analgesics & suturing of right forearm. Patient had no H/O Loc/Ent bleed.

Patient had come at Sai ortho care hospitals for further management.

When patient was received at sai ortho care hospitals patient was observed to be in “HYPOVOLAEMIC SHOCK.” Patient was resuccitated with IV fluids & dressing of the compound wound over left femur was done. Patient was immediately shifted to ICU & was stabilized vitals was found stable. O2 support given due to de – saturation. Skin traction for both lower limbs was given. Wound swab from compound wound sent for Culture & Sensitivity.

X – rays taken for both lower limbs. Patient was diagnosed with

Fracture shaft of femur right side.

Comminuted compound fracture femur left side.

Fracture both bones left leg.

Comminuted fracture distal tibia & fibula right side.

After stabilizing the patient, fracture fixation was planned as a 3 stage procedure.

Stage 1: (30.06.2015)

Intramedullary nailing of right femur & external fixator application of left femur with wound debridement done on 30.06.2015.B.K.Slab given for both legs.

Stage 2 : (05.07.2015)

External fixator removal & intramedullary nailing of left femur. O.R.I.F. for right ankle done on 05.07.2015.